Re HRT (WDDTY vol 13 no 2), if the risk of death or disease is increased by a certain percentage, then I feel less than informed if you don’t say what the original percentage of risk was. If the original risk was 0.5 per cent, an increase of 51 per cent still makes the risk 0.75 per cent - worth taking to me. But if the original risk was 5 per cent, then its rise to about 7.5 per cent is significant, and I would reconsider not taking HRT. The original risk figures must be given alongside to make sense of the data.

To keep working, you need to maintain a cheerful frame of mind and have plenty of energy. Hot flushes are indeed trivial, but depression and tiredness (partly from waking at night from hot flushes) may stop you working when you can’t afford a career break. Modern women must continue to earn a living and it’s not a trivial matter. When they are at risk of not doing so, ageism can be unforgiving.

Chinese medicine was very effective for energy and cheerfulness - probably because of the unmeasured amounts of phytoestrogens - more so than NHS HRT, but was hopelessly expensive. - Anna Rahman, Brighton

WDDTY replies: The relative risk of cancer is, at best, a crude yardstick derived from the number of cases across the whole population, although cancer is highly influenced by lifestyle. But breast cancer is the leading cancer in women, with more than 38,000 new cases in the UK each year, and one in four women will die of it. So, a 30 per cent increase is cause for justifiable worry.

The risk of HRT, in our view, is magnified by the fact that there are many safe and inexpensive alternatives. Aside from phytoestrogens, you might consider homoeopathy or acupuncture, both of which have evidence of success against menopausal symptoms.

There is no reason to endure uncomfortable symptoms or expose yourself to the proven dangers of an unnecessary drug.

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